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Adobe PDF   Postsecondary Student Unpaid Work Placement Workplace Insurance ClaimThe file you are about to download will ONLY work properly if opened with an Adobe Reader 10 or later client. Please do not open this file in a browser.Fill & Print141.0 kb

Form Classification
Classification / Identification:
 Form Number:022-13-1352EEdition date: 2017/10 
 Title:Postsecondary Student Unpaid Work Placement Workplace Insurance Claim
 Ministry:Training, Colleges and Universities  
 Branch/ABC:Programs Branch  
 Program:Literacy and Basic Skill (LBS)  
 Purpose of Form:Track Post secondary students who incur a serious occurance on work placements  

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